Individual provider Active NPI

Amanda Apodaca Blancas, FNP-C, PMHNP-BC

  • Primary Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1043476971
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
692637 Issued in TX
Practice address
2415 E Camelback Rd Ste 700
Phoenix, AZ 85016-4245
Phone
(888) 279-0002
Fax
(915) 534-1289
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP116908 TX
Family Nurse Practitioner 363LF0000X 692637 TX
Primary Care Nurse Practitioner 363LP2300X 692637 TX Primary

Addresses

Primary practice location

2415 E Camelback Rd Ste 700
Phoenix, AZ 85016-4245

Mailing address

2415 E Camelback Rd Ste 700
Phoenix, AZ 85016-4245
Phone (888) 279-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP116908TXMDNurse Practitioner
692637TXMDPrimary Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: amanda.blancas.1@22469.direct.athenahealth.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1043476971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 E CAMELBACK RD STE 700",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164245",
            "telephone_number": "888-279-0002",
            "fax_number": "915-534-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 E CAMELBACK RD STE 700",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164245",
            "telephone_number": "888-279-0002",
            "fax_number": "915-534-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCAS",
        "first_name": "AMANDA",
        "middle_name": "APODACA",
        "credential": "FNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2025-06-03",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP116908",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "692637",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "692637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.